High-Resolution Tomography-Based Quantification of Cortical Porosity and Cortical Thickness at the Surgical Neck of the Humerus During Aging

Helfen, Tobias; Sprecher, Christoph M.; Eberli, Ursula; Gueorguiev, Boyko; Müller, Peter E.; Richards, R. Geoff; Schmidutz, Florian

doi:10.1007/s00223-017-0279-y

Cited by 22 publications

(16 citation statements)

References 39 publications

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“…Finally, microarchitectural changes of cortical bone in humeral head region could not been analyzed in the study. Some authors recently reported that cortical porosity and thickness has signi cant impact on bone loss and mechanical stability [8,9,11]. So our data were limited in predicting the risk of proximal humeral fractures.…”

Section: Discussionmentioning

confidence: 83%

“…Proximal humerus fragility in old age is usually attributed to age-related bone loss [4,9]. However little is known about the cortical changes in speci c regions of the humeral head.…”

Section: Discussionmentioning

confidence: 99%

“…However, cortical bone makes up approximately 80% of the skeletal mass of an adult, particularly at appendicular sites where the cortex accounts for the majority of axial load transfer [6,7]. In the femoral neck, complete removal of trabecular bone leads to an only 7% reduction in load needed to fracture [7].Recent studies on radius, femur and humerus had found the vast majority of bone loss is cortical, not trabecular, and occurs age over 65 years by intracortical remodeling [8,9]. Marked thinning and high porosity of femoral neck cortex with advancing age had been shown to result in increased fracture incidence [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…Marked thinning and high porosity of femoral neck cortex with advancing age had been shown to result in increased fracture incidence [10][11][12][13]. Structural property of cortical bone is a key element of bone strength, although trabecular bone may be the rst site to display obvious microarchitectural weakness [8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Sex differences in cortical bone of humeral head region

Wang

Yang

et al. 2020

Preprint

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Background Proximal humerus fractures are highly related to age, and are particularly high in women. The goal of this study was to investigate sex-related similarities and differences in humeral head structure. Methods Computed tomography (CT) scans of 147 healthy subjects (76 men /71 women) spanning a wide range of ages (20-88 years) were analyzed. Three groups of subjects were identified according to age: group A (aged 20-39 years), group B (aged 40-59 years), and group C (aged> 60 years). For each subject, cortical bone mapping (CBM) was applied to create color 3D thickness map for the proximal humerus. Regions of interest (ROI) were defined in three walls of humeral head which corresponded to the anterior, lateral and posterior aspects. Cortical parameters, including the cortical thickness (CTh), cortical mass surface density (CM), and the endocortical trabecular density (ECTD) were measured using CBM. Results In both sexes, the CTh value of proximal ROIs in lateral and anterior wall tended to decrease with age. No significant difference was detected between three age groups for each parameter in the posterior wall in men and women. In ROIs 1-9, the ECTD tended to show a notable decline with age in women. In contrast, the ECTD remained unchanged in men. When pooled across all decades, the CTh, CM and ECTD values of ROI 1-9 were approximately equivalent between men and women. Conclusions There was no sex difference in cortical bone parameters in the humeral head region. However, the endocortical trabecular density decreased significantly with age only in women.

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Section: Discussionmentioning

confidence: 83%

“…Proximal humerus fragility in old age is usually attributed to age-related bone loss [4,9]. However little is known about the cortical changes in speci c regions of the humeral head.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sex differences in cortical bone of humeral head region

Wang

Yang

et al. 2020

Preprint

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“…However, the cortical bone thickness itself may be different depending on the individual characteristics [ 14 ]. In addition, the thickness of the cortical bone may change according to the intracortical remodeling between the cortical bone and the cancellous bone [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of mandibular cortical bone ratio on computed tomography images in patients taking bisphosphonates

Koo

Lee

2018

Maxillofac Plast Reconstr Surg

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BackgroundBisphosphonate (BP) has the ability to thicken the cortical bone. In addition, it has been reported that the cortical bone thickened by BP has relation to the medication-related osteonecrosis of the jaw (MRONJ). Therefore, the objective of this article is to analyze the ratio as well as thickness of cortical bone in the mandible using computed tomography (CT) and to evaluate it as the predictive factor of MRONJ.MethodsThe thickness of the cortical bone was measured on a paraxial view of the CT showing the mental foramen in 95 patients: 33 patients with MRONJ (3 males, 30 females), 30 patients taking BP without MRONJ (2 males, 28 females), and 32 controls (9 males, 28 females). Also, the ratios of the cortical bone to the total bone were obtained using the measured values. Based on these results, we compared the difference of mandibular cortical bone ratio between the three groups.ResultsThe average cortical bone thickness was measured as 3.81 mm in patients with MRONJ, 3.39 mm in patients taking BP without MRONJ, and 3.23 mm in controls. There was only a significant difference between patients with MRONJ and controls (P < 0.05). On the other hand, the average mandibular cortical bone ratio was measured as 37.9% in patients with MRONJ, 27.9% in patients taking BP without MRONJ, and 23.3% in controls. There was a significant difference between all groups (P < 0.05).ConclusionThe mandibular cortical bone ratio is large in order of patients with MRONJ, patients taking BP without MRONJ, and controls. This result suggests that the mandibular cortical bone ratio would be very useful to predict the development of MRONJ.

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Investigation of distal femur microarchitecture and factors influencing its deterioration: An ex vivo high‐resolution peripheral quantitative computed tomography study

Schmidt

Riedel

Stürznickel

et al. 2022

Journal Orthopaedic Research

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While fractures of the distal femur are often considered as fragility fractures, detailed knowledge of the bone microarchitecture at this skeletal site is largely unavailable. Initial evaluation of a patient cohort with distal femur fractures showed a markedly increased occurrence in elderly women. The purpose of this study was to determine the extent to which demographic characteristics of distal femur fractures are reflected by general age‐ and sex‐specific variations in local microarchitectural parameters. Fifty cadaveric femora were collected from 25 subjects (12 females, 13 males, age 25–97 years). A volume of interest within 3 cm proximal to the condyles was analyzed using high‐resolution peripheral quantitative computed tomography (HR‐pQCT), which revealed impaired trabecular and cortical bone microarchitecture in women compared to men as well as in osteoporotic compared to normal or osteopenic subjects, as classified by dual‐energy X‐ray absorptiometry (DXA) T‐score. Linear regression analyzes showed negative associations between age and HR‐pQCT parameters in women (e.g., cortical thickness −14 µm/year, 95% CI: −21 to −7 µm/year), but not in men (e.g., cortical thickness 1 µm/year, 95% CI: −12 to 14 µm/year). HR‐pQCT parameters showed strong positive associations with areal bone mineral density (aBMD) determined by DXA at the hip in both sexes. Taken together, our findings suggest that female sex, advanced age, and low aBMD represent major risk factors for impaired microarchitecture at the distal femur. Both the diagnostic value of DXA for predicting distal femur fractures and the efficacy of bone‐specific agents on fracture risk reduction should be investigated in the future.

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High-Resolution Tomography-Based Quantification of Cortical Porosity and Cortical Thickness at the Surgical Neck of the Humerus During Aging

Cited by 22 publications

References 39 publications

Sex differences in cortical bone of humeral head region

Sex differences in cortical bone of humeral head region

Evaluation of mandibular cortical bone ratio on computed tomography images in patients taking bisphosphonates

Investigation of distal femur microarchitecture and factors influencing its deterioration: An ex vivo high‐resolution peripheral quantitative computed tomography study

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